Advertisement

Author: Jakob Emerson

The investment arm of Marietta, Ga.-based Wellstar Health System, Catalyst by Wellstar, has invested in Venteur, a digital health startup that administers Individual Coverage Health Reimbursement Arrangement plans. ICHRAs allow employers to contribute tax-free dollars to employees’ health benefits, which…

Moody’s Ratings has downgraded UnitedHealth Group’s outlook from stable to negative, citing “a number of adverse trends simultaneously.”  The ratings agency also affirmed the company’s strong credit ratings, including its long-term issuer and senior unsecured debt ratings, as well as…

Cigna and Pittsburgh-based Allegheny Health Network will be out of network on July 1 without a new contract in place, the Pittsburgh Business Times reported. According to the report, about 20,000 Cigna members have used an AHN provider within the…

Seventeen percent of initial Medicare Advantage claims are denied, but 57% of originally denied claims are ultimately overturned, according to a study published June 2 in Health Affairs. The study analyzed 270 million claims from 2019 based on data from…

Advertisement

Nebraska Gov. Jim Pillen has signed the Ensuring Transparency in Prior Authorization Act, which aims to overhaul the prior authorization process in the state by making prior auth requirements publicly available on insurers’ websites and ensuring that providers are given…

UnitedHealth Group is exploring the sale of its Banmedica subsidiary, which operates in Colombia and Chile, Reuters reported June 9. The company has been trying to exit Latin America since 2022, but the reported sale has taken on increasing urgency…

Deceptive marketing practices, including deepfake AI versions of celebrities like Taylor Swift and Joe Rogan, have led to fraudulent enrollment in ACA plans in recent years, according to a June 5 report from Bloomberg. Primarily in 2022 and 2023, AI-created…

The country’s largest Medicare Advantage carriers are backing significant proposed reforms to billing practices, along with new crackdowns and audits of the plans. CMS Administrator Mehmet Oz, MD, has promised scrutiny of the Medicare Advantage program amid allegations of widespread…

Advertisement